Preparing For A Future That Includes Aging Parents

Natasha Shamone-Gilmore (right) attends church with her husband, Curtis Gilmore (center), and her father, Franklin Brunson, 81. Shamone-Gilmore moved Brunson into her Capitol Heights, Md., home after he developed dementia.

"Dad, wake up. Do you know what day it is?" Natasha says to her father during her daily morning routine. The family had a friend install a makeshift wall in their living room to create a bedroom for Franklin.

"In the morning my head is spinning, because I'm thinking of all the things that have to be done," Natasha says. Not only does she care for her father, but her 24-year-old son, Nicholas, also lives in the family home.

Nicholas (left) laughs with his childhood friend Corey Buford while they work on Nicholas' car. Nicholas has briefly abandoned his music aspirations and is close to getting a job with Comcast to install cable. "The money is more important," Nicholas says. "I need something that I can contribute [to the household] with."

Natasha and Curtis pray during Sunday worship at The Sanctuary Baptist church in Capitol Heights, Md. "She is always trying to take care of someone or something — a dog, a cat, a bird," Franklin says of Natasha. "She has been that way since she was knee-high."

Natasha Shamone-Gilmore (right) at church with her husband, Curtis Gilmore (center), and her father, Franklin Brunson, 81. Shamone-Gilmore moved her father into her Capitol Heights, Md., home after he developed dementia.

She thinks about it a lot these days. Shamone-Gilmore, a computer trainer in Maryland, now shares a modest home with her husband, 24-year-old son and 81-year-old father.

Like millions of other middle-aged Americans, she had long regarded her parents as robust adults, more than capable of managing their own affairs. "My mom was a very active woman; my dad ... was a Safeway employee for 40-something years," she said.

But time does what it does, and today, her father needs a caretaker. So she has had to step into that role and figure out how to make it all work financially.

Shamone-Gilmore's family is one of three multigenerational households being profiled by NPR this spring. Their stories will help highlight the importance of family financial planning. The series, Family Matters, began last week and will continue in installments each Tuesday into June.

While aging is inevitable, planning for the costs associated with dependency in the latter phase of life doesn't come easily to most Americans.

"People dread talking about it because we don't like to face our mortality," says Jack Hetherington, a certified elder-law attorney in suburban Philadelphia. He estimates that fewer than 1 person in 5 takes even the first steps needed to prepare legally and financially for taking care of an incapacitated parent.

Consider this contrast between expectations and reality:

Only 13 percent of some 4,000 U.S. workers surveyed for the 2011 Aflac WorkForces Report believe that the need for long-term care would affect their families.

And yet providing long-term care is, in fact, common. Nearly 10 million adult children are caring for aging parents, according to the MetLife Mature Market Institute. Other adult children are contributing to the cost of a parent's assisted-living care, which MetLife says averages about $3,500 a month.

"The percentage of adult children providing personal care and/or financial assistance to a parent has more than tripled over the past 15 years," the research group found.

Of course, in today's tough economy, it also is common for elderly adults to be supporting their adult children. But in some ways, that's easier to accept: Parents often plan to leave whatever wealth they have to their children anyway. The flow of wealth from older to younger generation feels natural to many.

But with Americans living so much longer now, the younger generation has to do more thinking about how they might care for parents who have exhausted their savings.

"That's a tough one," says Paul Taylor, director of the Pew Research Center's Social and Demographic Trends project. "You have lots of uncertainties in your own life, let alone worrying about paying for your parents' care."

So like many other baby boomers, Shamone-Gilmore is struggling with bills, and hoping to reform her family for the future.

"Now that it's happened to us, and I am the household coordinator, I am now trying to educate the entire family that: You guys need to get in line," she says. "We're not thinking. No one is thinking."

Experts say any serious plan for caring for aging parents must begin — not with discussions about money — but with a legal document designating someone as having "power of attorney." That paperwork grants authority to another individual to handle decisions if a loved one can't make them as a result of illness or memory loss.

"The purpose is to provide a safety net in case of incapacity," Hetherington says. "If you wait too long and you don't have the capacity to make decisions, you end up in guardianship court, and that could involve lawyers, doctors, judges, time and money."

Once the legal paperwork is done, families can turn to an array of sources for legitimate advice on boosting savings, buying appropriate insurance and maximizing home equity.

For example, many employers offer workplace benefits that include free financial planning services. Credit unions can help, too. Public library shelves are loaded with books on how to get started making a financial plan, and websites, such as HelloWallet and Mint.com, offer help.

Hetherington says taking those first steps can be difficult. "But it's the only way of avoiding problems down the road," he says.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

STEVE INSKEEP, HOST:

One of every six American families now lives in a multigenerational household - three generations or more under one roof. [POST-BROADCAST CORRECTION: This statistic comes from a recent study by the Pew Research Center, but in its definition of multigenerational households, Pew includes homes with two generations of adults from one family; for example, children over age 25 who have moved back in with parents, or elderly parents who have joined their middle-aged children under one roof.]

That's a huge increase over the last few decades. It's a huge change in American life, and it can be a huge financial and emotional challenge for the people living in those households - people we are learning from in a series we call "Family Matters." Last week, our MORNING EDITION colleague David Greene introduced us to three families we're following over these weeks - eight weeks in total. Hi, David.

DAVID GREENE, BYLINE: Hi, Steve.

INSKEEP: He's back with us again. And who are we visiting this week?

GREENE: Well, one of our families, Steve, lives in Capitol Heights, Maryland, and they're dealing with all the pressures that you're talking about. And the first voice you're going to hear is Natasha Shamone-Gilmore. She's 58 years old. She works as a computer trainer at a nonprofit, and she lives in one of these multigeneration households. She lives with her husband; also, her 24-year-old son; and her father, Franklin Brunson. Now, he had been living in North Carolina until about two years ago. And that's when Natasha got this anonymous phone call that really changed her life.

NATASHA SHAMONE-GILMORE: Someone called me and said hi, you don't know me. Are you Mr. Russell's daughter? I said yes, I am. And they said, your dad's in trouble. And I said oh, OK. And I immediately packed up and went to North Carolina.

GREENE: And so, Steve, she found her father totally confused - an elderly man - his finances in disarray. And Natasha realized at that moment that she had to move him back home with her to Maryland.

INSKEEP: It doesn't sound like this is something the family was expecting.

GREENE: It wasn't something they were expecting at all. I mean, they were totally unprepared. You know, Natasha lives in this cramped, two-bedroom house. There wasn't really room to move her elderly father in, so the family had a friend put up this makeshift drywall in the middle of the living room, to create a bedroom for him.

INSKEEP: So he's living with them now, and I suppose they were hoping that he could be reasonably self-sufficient.

GREENE: Reasonably, but that hasn't turned out to be the case. So Franklin Brunson, he's 81 years old. And he has dementia, and it's just gotten worse and worse. He's also a man who's partially blind. And last winter, the family just had this awful scare. Mr. Brunson was kind of having a bad day. He wanted to escape the house and he took off with Natasha - his daughter's car, and he went missing, Steve, for two days.

SHAMONE-GILMORE: He ended up on the wrong side of the road, driving up and down on black ice. And residents called the state troopers, and the state troopers got him and put the car to the side.

GREENE: And so, Steve, Franklin Brunson did make it home OK. But, I mean, you could just imagine how frightening this was. It was, of course, a real turning point. Natasha realized that she just couldn't leave her dad alone anymore. And I met Natasha. She's this tall, elegant woman. She was in a business suit the morning we spoke, ready to go to her full-time job. She loves her father so much, but you can just feel the stress that she's feeling right now.

SHAMONE-GILMORE: So in the morning, my head is spinning because I'm thinking of all the things that have to be done - and it's a lot. Anyway.

GREENE: And so, Steve, one decision that she made, one thing that she did, was she decided to put her father in an adult day center during the day. It was an emotional decision, but if she was going to keep working full time, she had to find a place for her father to go. And we really wanted to understand what a place like this is like and also, how much it costs. I mean, this is an expensive decision for a family. And so we went along with Natasha's dad, Franklin Brunson, to the Crescent Ridge Adult Day Center outside Washington, D.C.

UNIDENTIFIED WOMAN #1: Good morning.

SHAMONE-GILMORE: Good morning.

UNIDENTIFIED WOMAN #1: Hey...

UNIDENTIFIED WOMAN #2: How are you all doing?

SHAMONE-GILMORE: Fine.

UNIDENTIFIED WOMAN #2: Mr. Brunson, hello.

FRANKLIN BRUNSON: I'm fine, fine. How are you doing?

UNIDENTIFIED WOMAN #2: I'm doing great, now that I see you.

GREENE: The several dozen residents who spend their days here suffer from dementia, Alzheimer's or various brain injuries. Now, when we spent some time with Franklin Brunson early in the morning at his daughter's house, he seemed antsy, really quiet. He spent most of the time staring blankly. But his energy and personality burst out during the day. A few minutes after Natasha drops him off, Brunson is holding court at a round table in the center's sun-splashed main room. I asked him about something I'd heard, that he was one heck of a bowler.

I hear you're the bowling champion.

BRUNSON: Oh, I'm not a bowling champion. If I was, I wouldn't be sitting here.

GREENE: Brunson and his friends spend hours talking about whatever happens to be on their minds. Today, it's death. They were chatting about musicians who died young, like Whitney Houston.

BRUNSON: Did she have to die, why she died - earlier? But we don't know. At least, that's what I was telling them. I do not know.

GREENE: Brunson wasn't just thinking about the untimely death of a singer. He was reflecting on the clock running out on his own life.

BRUNSON: That was her time, her time to go, not mine.

GREENE: These kinds of interactions are no accident. One of the goals of adult day centers is to keep the mind working, and we wanted to talk about that with the director here.

COREY ODOL: Hi. How you doing?

GREENE: Corey Odol is the psychologist who directs Crescent Ridge, and he says the care here is more meaningful, if families catch dementia or Alzheimer's early.

ODOL: This is usually the right option when it's early diagnosis; when we're realizing that Mom and Dad can no longer stay at home, when we're realizing that they need social oversight, when they need supervision, when they need medical oversight.

GREENE: This decision - about how to care for an elderly parent when a disease like dementia sets in - is one facing more and more people.

ODOL: Years ago, elderly parents didn't live as long as they do today.

GREENE: And the fact that people are living longer puts more financial pressures on the people caring for them. Attending Crescent Ridge costs $78 a day. It's pretty typical for adult day centers like this. Medicaid will cover some, or all, of the costs. Families who don't qualify for Medicaid often come for a tour of Corey's adult day center and then leave, realizing they just can't afford the cost out of pocket. But financial pressures aside, the emotion Corey often sees when a new family comes in is confusion.

ODOL: There are people that will walk into the door and say: I don't know what to do. All I know is that I need help with my mom or my dad, or my grandmother or my grandfather.

GREENE: One of the other families we're following lives here, in an apartment south of Baltimore. They, too, are caring for a loved one with dementia, and they've made an entirely different choice. Yolanda Hunter says her family never considered an adult day center for her grandmother.

HUNTER: They let them sit. They'll give them their lunch, and then that's it. So it's extremely expensive, but you're not paying for quality.

GREENE: Quality care is what Yolanda says she gives her grandmother personally. Two years ago, she quit her job to become a full-time caregiver. She spends every day with her grandmother, Ida Christian.

HUNTER: Sing your favorite song.

CHRISTIAN: What is my favorite song?

HUNTER: OK. I'm going to say the first couple of words - it's your thing. Do what you wanna do.

CHRISTIAN: (Singing) It's your thing, do what you wanna do. I can't tell you who to sock it to. Oh, it's your thing, ba ba ba...

GREENE: And so, Steve, I've just been hearing a lot of touching moments like these.

INSKEEP: That's NPR's David Greene. And David, as people are listening - I'm sure there are many, many people - maybe millions of people - hearing this story who can directly relate to it in their own lives. Is there someplace that people can go to share their stories, or even find each other?

GREENE: Yeah. And I mean, that is, really, one of the things we want to do with this series - make it a real conversation. And listeners who are hearing these stories, they can go to our MORNING EDITION Facebook page and - certainly - share their stories and experiences.

INSKEEP: You can also go to npr.org, where you can find pictures of the three families David is following. David, we'll talk to you again next week.